Catheters for the introduction or removal of fluids may be located in various venous locations and cavities throughout the body of a patient for introduction of fluids to the body or removal of fluids from the body. Such catheterization may be performed by using a single catheter having multiple lumens. A typical multiple lumen catheter is a dual lumen catheter in which one lumen introduces fluid and the other lumen removes fluid. An example of such a multiple lumen catheter assembly is the SPLIT-CATH® catheter. Catheterization may also be performed by using separate, single lumen catheters inserted through two different incisions into an area to be catheterized. An example of such a catheter assembly is a TESIO® catheter.
Generally, to insert any catheter into a blood vessel, the vessel is identified by aspiration with a long hollow needle in accordance with the well known Seldinger technique. When blood enters a syringe attached to the needle, indicating that the vessel has been found, a thin guide wire is then introduced, typically through a syringe needle or other introducer device into the interior of the vessel. The introducer device is then removed, leaving the end portion of the guide wire that has been inserted into the vessel within the vessel and the opposing end of the guide wire projecting beyond the surface of the skin of the patient. At this point, several options are available to a physician for catheter placement. The simplest is to pass a catheter into the vessel directly over the guide wire. The guide wire is then removed, leaving the catheter in position within the vessel. However, this technique is only possible in cases where the catheter is of a relatively small diameter, made of a stiff material, and not significantly larger than the guide wire, for example, for insertion of small diameter dual lumen catheters. If the catheter to be inserted is significantly larger than the guide wire, a dilator and sheath device is passed over the guide wire to enlarge the hole. The dilator and the guide wire are then removed from the sheath, leaving only the sheath. The catheter is then inserted through the sheath and into the vessel. The sheath is then removed from around the catheter by tearing the sheath as the sheath is being removed from the patient.
For chronic catheterization, in which the catheter is intended to remain inside the patient for extended period of time, such as for weeks or even months, it is typically desired to subcutaneously tunnel the catheter into a patient using various tunneling techniques. The catheter is typically tunneled into the patient prior to inserting the catheter into the patient's vein. The subcutaneous tunnel provides a stable anchor to prevent the proximal end of the catheter from moving and possibly becoming dislodged, which could result in patient injury or death. An anchoring cuff typically circumscribes a portion of the catheter assembly that is located within the tunnel, allowing skin tissue to grow in and around the cuff, further stabilizing the catheter.
Catheter assemblies typically include a hub that connects a proximal end of each catheter lumen with a distal end of an extension tube. Occasionally, a blood clot may form in a catheter lumen at a junction between the catheter lumen and the hub, cutting off blood flow through the catheter lumen. Such an occasion typically necessitates removal of the entire catheter assembly from the patient, including insertion of a new catheter assembly in place of the failed catheter assembly. Part of this removal includes separating the skin from the cuff in the subcutaneous tunnel, and pulling the catheter assembly through the tunnel, as well as removing the catheter lumens from the patient's blood vessel. The removal of the failed catheter assembly and the insertion of the new catheter assembly causes additional trauma to the patient, which is not desired.
It would be beneficial to be able to repair a clogged catheter lumen without having to remove the entire catheter assembly from the patient and inserting a new catheter assembly.